MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION NPI 1184719155

NPI Information

NPI: 1184719155
Provider Name: MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 15D0936172

Address:
695 3RD AVE
JASPER, IN
ZIP 47546
Phone: (812) 634-6824
Get Directions

MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION is an urgent care clinic center in Jasper, IN. MEDICAL OF DUBOIS A PROFESSIONAL CORPORATION NPI is 1184719155. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

695 3RD AVE
JASPER, IN
ZIP 47546-602
Phone: (812) 634-6824
Fax: (812) 848-2277

The provider's authorized official is Thomas E Field .
The authorized official title is President and has the following contact phone number (812) 634-6824.

The CLIA number assigned to this NPI record is 15D0936172 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 5/26/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		01025667	INDIANA	No
2	261QU0200X	Clinic/Center	Urgent Care	01025667	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DF6038	OTHER	INDIANA	MEDICARE RAILROAD
2	M100061947	MEDICARE PIN	INDIANA
3	000000310221	OTHER	INDIANA	ANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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